Provider Demographics
NPI:1245949015
Name:NURTURING MAMA, LLC
Entity type:Organization
Organization Name:NURTURING MAMA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHANDLI
Authorized Official - Middle Name:
Authorized Official - Last Name:JOYCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-760-1344
Mailing Address - Street 1:4711 VANN RD
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-7447
Mailing Address - Country:US
Mailing Address - Phone:812-760-1344
Mailing Address - Fax:
Practice Address - Street 1:4711 VANN RD
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-7447
Practice Address - Country:US
Practice Address - Phone:812-760-1344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-21
Last Update Date:2025-03-03
Deactivation Date:2023-10-16
Deactivation Code:
Reactivation Date:2025-03-03
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty